Copyright 1999 The Times-Picayune Publishing Co.
The Times-Picayune
July 2, 1999 Friday, ORLEANS
SECTION: NATIONAL; Pg. A3
LENGTH: 849 words
HEADLINE:
REPORT: BETTER DEFINE DISABLED;
INEQUITIES FOUND IN SSI PROGRAM FOR CHILDREN
BYLINE: By Bruce Alpert Washington bureau
DATELINE: WASHINGTON
BODY:
The Social Security Administration needs to better define the medical
conditions children must have to qualify for disability benefits to ensure more
equity in a program where denial rates differ dramatically from state to state,
a new congressional report concludes.
Using tougher criteria adopted by
Congress, the Social Security Administration has been reviewing the rolls of
child recipients of the Supplemental Security Income program since 1997. About
42 percent of the 273,000 cases reviewed were found to be ineligible. But in
some states the denial rates were much higher. In Louisiana, for example, 75
percent of the 11,322 child cases reviewed were found ineligible for continued
benefits. That left 31,324 child SSI recipients in Louisiana, with average
benefits of $448 a month.
Advocacy groups for the disabled, who fought
hard against the new eligibility criteria, maintain that deserving youngsters
are being denied benefits, particularly in states like Louisiana.
But
the Social Security Administration said it has begun an evaluation system that
continues services for the most needy children, while cutting off benefits only
to less severely disabled children to reflect the will of Congress.
In a
report issued Wednesday, the General Accounting Office, the investigatory arm of
Congress, said the Social Security Administration has made "significant
progress" in implementing the reforms ordered by Congress, completing reviews of
98 percent of the cases subject to the new eligibility criteria.
But it
said the agency needs to upgrade its listings of medically eligible conditions
to eliminate "inconsistencies." So far, the agency hasn't set a timetable for
doing so, GAO said.
"Until SSA completes this initiative, its medical
listings for childhood impairments will continue to reflect multiple levels of
severity and therefore will not ensure equity among children receiving SSI
disability benefits," the GAO said.
SSI benefits for disabled children
are designed to let low-income families purchase extra equipment or schooling to
help their disabled children lead as normal a life as possible. The program was
quite popular with members of Congress, until a Supreme Court ruling in 1990
significantly increased eligibility, with the rolls ballooning threefold to 1
million children by the mid-1990s.
Congress rewrote the rules, removing
a provision the Supreme Court had liberally interpreted that allowed children to
qualify by showing they had trouble functioning with their peers. That general
definition allowed some parents to coach their children to "act crazy," and
qualify for benefits that they weren't entitled to, critics said.
Under
the new rules, a child qualifies by exhibiting one of 28 medical conditions
listed in Social Security regulations as an impairment, or by demonstrating that
the child's condition is "equal" to any of the listed conditions. Under the
rules, a disability is defined as a physical or mental condition that is
expected to last at least 12 months, or expected to result in death.
In
addition to Louisiana, other states with higher than average denial rates for
SSI children's benefits are Mississippi, Texas, Tennessee, Alabama, Arkansas and
Oklahoma.
Last year, Social Security Commissioner Kenneth Apfel conceded
that some children were being removed from the rolls by mistake, and promised
not to cut off benefits for those pursuing an appeal. So far, the agency has
heard about 21,800 appeals nationwide, and restored benefits to 5,000, or 23
percent. That's slightly below the 25 percent successful appeal rate for the
3,959 Louisiana appeals heard so far.
The agency said its own review
found no significant mishandling of cases in the states with higher than normal
rejection rates. But it conceded that some of the states with high rejection
rates were turning away a disproportionate number of applicants for "failure to
cooperate," meaning that parents missed scheduled meetings or failed to file
proper forms.
It said sometimes people being removed for this reason
weren't given the required notice, adding that some lived in rural communities
and had a tough time making appointments many miles away. But Social Security
officials said that steps have been taken to make sure cases aren't being closed
without proper notice.
Advocacy groups continue to protest that the
agency has interpreted the new rules too severely, denying benefits to needy
children, particularly those with severe mental retardation or mental illness.
"I think they have been overly and unrealistically restrictive in
handling cases of kids with serious multiple problems," said Jonathan Stein, a
lawyer with Community Legal Services in Philadelphia.
Nancy Goodwin,
senior paralegal with Acadiana Legal Services Corp. in
Lafayette, said her group has had success restoring benefits to dozens of
children.
"But our concern is that people who are going into these
appeal hearings without representation aren't faring so well," Goodwin said.
"There are still too many people being denied benefits who really need them."
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